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Body Mass Index Z Score vs Weight-for-Length Z Score in Infancy and Cardiometabolic Outcomes at Age 8-10 Years

Authors: Roberge JBHarnois-Leblanc SMcNealis Vvan Hulst ABarnett TAKakinami LParadis GHenderson M


Affiliations

1 CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, University of Montréal, Montréal, Canada.
2 CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; School of Public Health, University of Montréal, Montréal, Canada.
3 CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada.
4 Ingram School of Nursing, McGill University, Montréal, Canada.
5 CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Family Medicine, McGill University, Montréal, Canada.
6 Department of Mathematics and Statistics, McGill University, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada.
7 Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Canada.
8 CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, University of Montréal, Montréal, Canada; School of Public Health, University of Montréal, Montréal, Canada. Electronic address: melanie.henderson.hsj@gmail.com.

Description

Objectives: To confirm that World Health Organization weight-for-length z scores (zWFL) and World Health Organization body mass index z scores (zBMI) in infancy are associated with adiposity and cardiometabolic measures at 8-10 years old and to compare the predictive ability of the 2 methods.

Study design: zWFL and zBMI at 6, 12, and 18 months of age were computed using data extracted from health booklets, among participants in the Québec Adipose and Lifestyle InvesTigation in Youth prospective cohort (n = 464). Outcome measures at 8-10 years included adiposity, lipid profile, blood pressure, and insulin dynamics. The relationships between zWFL, zBMI, and each outcome were estimated using multivariable linear regression models. Outcome prediction at 8-10 years was compared between the 2 methods using eta-squared and the Lin concordance correlation coefficient.

Results: zWFL and zBMI were associated with all measures of adiposity at 8-10 years. Associations with other cardiometabolic measures were less consistent. For both zWFL and zBMI across infancy, eta-squared were highly similar and the Lin coefficients were markedly high (=0.991) for all outcomes.

Conclusions: There was no evidence that zBMI and zWFL in infancy differed in their ability to predict adiposity and cardiometabolic measures in childhood. This lends support to the sole use of zBMI for growth monitoring and screening of overweight and obesity from birth to 18 years.

Trial registration: ClinicalTrials.gov: NCT03356262.


Keywords: adiposityandroid-to-gynoid ratioblood pressurecardiometabolic healthchildhood obesitychildhood overweightinsulin secretioninsulin sensitivitylipid profilewaist circumferencewhole body fat


Links

PubMed: https://pubmed.ncbi.nlm.nih.gov/34302856/

DOI: 10.1016/j.jpeds.2021.07.046